Anti-Thrombotic Drugs Flashcards

1
Q

What are the classes of anti-thrombotic drugs?

A
  • Anti-platelet drugs
  • Anticoagulants
  • Fibrinolytics
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2
Q

What are examples of anti-platelet drugs?

A
  • Aspirin
  • Clopidogrel
  • Prasugrel
  • Ticagrelor
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3
Q

What are examples of anticoagulants?

A

Subcutaneous :
- Heparin
- Fondaparinux

Oral :
- Warfarin
- Rivaroxaban
- Dabigatran
- Edoxaban

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4
Q

What are examples of fibrinolytic drugs?

A
  • Streptokinase
  • Tissue plasminogen activator (tPA)
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5
Q

What do anti-platelet and anti-coagulant drugs prevent?

A

New thrombosis

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6
Q

What conditions are anti-platelet drugs used in?

A
  • Angina
  • Acute myocardial infarction (MI)
  • Cerebrovascular accident (CVA)
  • Transient ischaemic attack (TIA)
  • Patients at high risk of MI and CVA
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7
Q

What are some side effects of anti-platelet drugs?

A
  • Haemorrhage anywhere
  • Peptic ulcer leading to haemorrhage
  • Aspirin sensitivity leading to asthma
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8
Q

What is the mechanism of action of Clopidogrel, Ticagrelor and Prasugrel?

A
  • They inhibit the binding of ADP to its P2Y12 platelet receptor
  • This is thought to block the activation of the glycoprotein IIb/IIIa pathway
  • Thereby inhibiting platelet aggregation
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9
Q

What is the mechanism of action of aspirin?

A

Aspirin irreversibly inhibits cyclo-oxygenase (COX) and blocks the production of thromboxane A2 which is involved in platelet activation and aggregation

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10
Q

What conditions are anti-coagulant drugs like heparin and warfarin used in?

A
  • Deep vein thrombosis (DVT)
  • Pulmonary embolism (PE)
  • Non-ST elevated myocardial infarction (NSTEMI)
  • Atrial fibrillation (AF)
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11
Q

What is a side effect of anti-coagulant drugs?

A

Haemorrhage anywhere

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12
Q

What is International Normalised Ratio (INR) ?

A

The International Normalised Ratio (INR) blood test tells you how long it takes for your blood to clot. It is used to test clotting times in people taking warfarin.

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13
Q

How is INR calculated?

A

By comparing the patient’s prothrombin time (PT) to a reference value - PT is a measure of how long it takes for blood to clot

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14
Q

What is the mechanism of action of Rivaroxaban?

A

Factor Xa inhibitor

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15
Q

What is the mechanism of action of Dabigatran?

A

Thrombin factor IIa inhibitor

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16
Q

What does Factor Xa do?

A

Converts Prothrombin (II) to Thrombin (IIa) - key step in the formation of blood clots

17
Q

What do fibrinolytic drugs do?

A

Fibrinolytic drugs dissolve formed clots

18
Q

What conditions are fibrinolytic drugs used in?

A
  • STEMI
  • Pulmonary embolism (selected cases only)
  • Cerebrovascular accident (selected cases only)
19
Q

What is a serious side effect of fibrinolytic drugs?

A

Serious risk of haemorrhage

20
Q

In what conditions should fibrinolytic drugs be avoided?

A
  • Recent haemorrhage (some CVAs)
  • Trauma
  • Bleeding tendencies
  • Severe diabetic retinopathy
  • Peptic ulcer